Document Detail


Cushing's syndrome in pregnancy: an overview.
MedLine Citation:
PMID:  18209867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cushing's syndrome (CS) during pregnancy is a rare condition with fewer than 150 cases reported in the literature. Adrenal adenomas were found to be the commonest cause, followed by Cushing's disease. The gestation dramatically affects the maternal hypothalamic-pituitary-adrenal axis, resulting in increased hepatic production of corticosteroid-binding globulin (CBG), increased levels of serum, salivary and urinary free cortisol, lack of suppression of cortisol levels after dexamethasone administration and placental production of CRH and ACTH. Moreover, a blunted response of ACTH and cortisol to exogenous CRH may also occur. Therefore, the diagnosis of CS during pregnancy is much more difficult. Misdiagnosis of CS is also common, as the syndrome may be easily confused with preeclampsia or gestational diabetes. Because CS during pregnancy is usually associated with severe maternal and fetal complications, its early diagnosis and treatment are critical. Surgery is the treatment of choice for CS in pregnancy, except perhaps in the late third trimester, with medical therapy being a second choice. There does not seem to be a rationale for supportive treatment alone.
Authors:
Lucio Vilar; Maria da Conceição Freitas; Lúcia Helena C Lima; Ruy Lyra; Claudio E Kater
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Arquivos brasileiros de endocrinologia e metabologia     Volume:  51     ISSN:  0004-2730     ISO Abbreviation:  Arq Bras Endocrinol Metabol     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2008-01-22     Completed Date:  2008-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0403437     Medline TA:  Arq Bras Endocrinol Metabol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  1293-302     Citation Subset:  IM    
Affiliation:
Division of Endocrinology and Metabolism, Hospital das Clínicas, Federal University of Pernambuco, Recife, PE, Brazil. lvilar@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Cushing Syndrome / diagnosis*,  etiology,  therapy
Diabetes, Gestational / diagnosis
Diagnosis, Differential
Female
Humans
Hypothalamo-Hypophyseal System / physiopathology
Pre-Eclampsia / diagnosis
Pregnancy / metabolism*
Pregnancy Complications / diagnosis*,  etiology,  therapy
Pregnancy Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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